Form 1127 - Application For Extension Of Time For Payment Of Tax Due To Undue Hardship Page 4
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Form 1127 (Rev. 12-2011)
Signature and Verification
Interest. You will owe interest on any tax not paid by the due date
of the return, or the due date of any amount determined to be a
deficiency, regardless of whether an extension of time to pay the
This form must be signed and dated.
tax has been obtained. The interest runs until you pay the tax.
Individuals. If this application is for the tax shown on a joint return
Penalties. Penalties may be imposed if you fail to pay the tax
or a joint tax liability for an amount determined as a deficiency,
within the extension period granted.
both you and your spouse must sign and date this form. If your
spouse cannot sign, see Pub. 501, Exemptions, Standard
Specific Instructions
Deduction, and Filing Information.
Name, Address, and Identification Number
Privacy Act and Paperwork Reduction Act Notice. We ask for
the information on this form to carry out the Internal Revenue laws
Individuals. Enter your name, address, and social security number
of the United States. We need this information to ensure
(SSN) or individual taxpayer identification number (ITIN). If this
compliance with these laws and to properly grant extensions of
application is for the tax shown on a joint return or a joint tax
time to pay tax. Applying for an extension of time for the payment
liability for an amount determined as a deficiency, include both
of tax is voluntary. However, providing the requested information is
spouses’ names in the order in which they appear or will appear on
mandatory if you apply for the extension. Our legal right to ask for
your return, and enter the SSN or ITIN of the spouse whose name
the information requested on this form is based in sections 6001,
appears first.
6011, 6109, and 6161 and their regulations. If you fail to provide all
Corporations. Enter your company’s name, address, and employer
or part of the information requested, your application may be
identification number.
denied. If you provide false or fraudulent information, you may be
P.O. box. Enter your box number only if your post office does not
subject to penalties.
deliver to your street address.
You are not required to provide the information requested on a
Foreign address. Enter the information in the following order: city,
form that is subject to the Paperwork Reduction Act unless the
province or state, and country. Follow the country’s practice for
form displays a valid OMB control number. Books or records
entering the postal code. Do not abbreviate the country name.
relating to a form or its instructions must be retained as long as
their contents may become material in the administration of any
Part I
Internal Revenue law. Generally, tax returns and return information
are confidential, as required by section 6103. However, section
Request for extension. Enter the due date of your return (not
6103 allows or requires the Internal Revenue Service to disclose
including extensions) or the due date for paying the amount
the information to others as described in the Code. For example,
determined as a deficiency. Enter the date you propose to pay the
we may disclose this information to the Department of Justice for
tax and the amount of tax you owe. The date you propose to pay
enforcement of civil or criminal tax laws; to cities, states, the
the tax can be up to:
District of Columbia, and U.S. commonwealths or possessions to
• 6 months from the due date of your return (not including
administer their tax laws; to other countries under a tax treaty; to
extensions), if your request is for payment of the tax shown on your
federal and state agencies to enforce non-tax criminal laws; or to
return (the date you propose can be more than 6 months if you are
federal law enforcement and intelligence agencies to combat
out of the country), or
terrorism.
• 18 months from the date payment is due, if your request is for
The time needed to complete and file this form will vary
payment of an amount determined as a deficiency (an additional 12
depending on individual circumstances. The estimated burden for
months can be requested for a deficiency in exceptional
individual taxpayers filing this form is approved under OMB control
circumstances).
number 1545-0074 and is included in the estimates shown in the
Check the applicable box and enter the form number to which the
instructions for their individual income tax return. The estimated
tax you owe relates. Enter the tax year, if the tax you owe is figured
burden for all other taxpayers who file this form is shown below.
on a calendar year; if the tax you owe is figured on a fiscal year,
Recordkeeping .
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3 hr., 6 min.
enter the ending month, day, and year.
Learning about the
Part II
law or the form .
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. 55 min.
Preparing and sending
Reason for extension. In order for your application to be
the form to the IRS .
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. 3 hr., 25 min.
considered, you must provide a detailed explanation of the undue
If you have comments concerning the accuracy of these time
hardship that will result if you pay the tax on or before the due date.
estimates or suggestions for making this form simpler, we would
An extension will not be granted if you provide only a general
be happy to hear from you. See the instructions for the tax return
statement of hardship.
for which this form is filed.
Part III
Supporting documentation. You must attach:
• A statement(s) of your assets and liabilities, and
• An itemized list of your income and expenses for each of the 3
months prior to the due date of the tax.
Note. Once your request has been reviewed, additional conditions
may have to be met.
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